Hammer, Mallet, Claw … What’s the Difference?

Foot and ankle specialist Neptune Jersey Shore New Jersey

You say pa-TAY-to, I say pa-TAH-toe … some differences are merely how we use language (the eternal pop vs. soda debate, for example), while others are more meaningful. Here’s another one you may have heard—hammertoes, mallet toes, and claw toes. Is there a difference between these toe deformities, and if so, what is it?

As a matter of fact, there is a difference—although closely related, these are three different conditions. The distinction relates to which of the three toe joints are being affect—the base (where the toe meets the foot), middle joint, and the third joint at the tip.

• Mallet toes curve downward only at the joint closest to the tip of the toe.
• Hammertoes, by contrast, curve down at the middle joint, which often causes the toe to arc upward a bit as well and giving the appearance of a piano hammer.
• Claw toes are the whole package—the base joint bends upward, the middle joint downward, and the tip joint downward again, resembling a claw or hook.

There are a few other differences as well. While mallet toes and hammertoes generally tend to strike the second toe more than the others—especially when its longer than the great toe—claw toes are more likely to affect all four smaller toes at once.

While they’re all a little different in appearance, all three can arise as a result of faulty foot structures or improper footwear, all three are progressive (meaning they don’t get better on their own, and get worse without treatment), and all three can cause significant pain, balance issues, and trouble walking if not cared for.